四物汤对高龄粗隆间骨折PFNA术后隐性失血的影响

Effect of Siwu Decoction in Treatment of Hidden Hemorrhage after PFNA with Senile Intertrochanteric Fractures

目的观察四物汤对高龄粗隆间骨折PFNA术后隐性失血情况的影响,为临床应用中医药解决高龄粗隆间骨折术后隐性失血问题提供参考。方法 48例高龄粗隆间骨折PFNA手术患者,按患者术后是否口服中药四物汤分为治疗组和对照组,治疗组在常规抗感染、对症治疗以及饮食指导等基础上,从术后第3天开始连续口服四物汤汤剂10d。观察并记录所有患者身高、体质量、术中及术后显性失血量;检测并记录治疗前后血红蛋白(Hb)和红细胞比容(HCT)含量,应用Gross方程计算红细胞容量,进而推算出隐性失血量。结果治疗后治疗组Hb、HCT含量明显提高,隐形失血量明显改善(P<0.01),优于对照组(P<0.05)。结论四物汤可以改善高龄股骨粗隆间骨折患者PFNA术后隐性失血状况。

OBJECTIVE To observe the effect of Siwu decoction in treatment of hidden hemorrhage after PFNA with senile intertrochanteric fractures, and to provide the reference for TCM on the hidden hemorrhage with senile intertrochanteric frac- tures patients. METHODS Forty PFNA postoperative patients with senile intertrochanteric fractures patients were divided in- to the treatment group and the control group according to whether taking the decoction. On the basis of conventional anti-infec- tion symptomatic treatment and dietary guidance, the treatment group was also beginning to take Siwu decoction continuously after three days of surgery, taking for 10 d totally. All patients＂ height, body mass, intraoperative and postoperative overt blood loss volume were observed and recorded. Hemoglobin （Hb） and hematocrit（HCT） were tested and recorded before and after treatment. Red blood cell volume was calculated by Gross equation to evaluate the hidden hemorrhage volume. RESULTS After the treatment, Hb content in the treatment group increased significantly, hidden hemorrhage volume improved obvi- ously （P〈0.01）, which was better than that in the control group （P〈0.05）. CONCLUSION Siwu decoction can improve the hidden hemorrhage of senile intertrochanteric fractures patients after PFNA.